Hepatitis B (HBV) Safety in Zimbabwe

Hepatitis B virus (HBV) infection continues to be a major public health problem in Zimbabwe. It plays a large role in causing serious long-term liver problems, including chronic liver disease, scarring of the liver (cirrhosis), and liver cancer. HBV is a virus that attacks the liver and can cause both short-term (acute) and lifelong (chronic) infections. Because it often shows no symptoms in the beginning, many people do not know they are infected until they develop severe liver damage later in life. For this reason, prevention, early detection, and proper long-term care are essential parts of managing hepatitis B safely in the country.

Zimbabwe is considered a country with high levels of hepatitis B. Studies and regional data show that between 7% and 10% of adults are living with a chronic HBV infection, though this number can be higher or lower depending on a person's age, where they live, and their personal risks. The virus is even more common among people living with HIV, because the two infections can spread in similar ways. This high rate means millions of Zimbabweans have been exposed to HBV, creating a heavy load for the healthcare system. Unfortunately, detailed national data is limited, and many cases go unreported because testing is not widespread and routine screening is not always available.

The health impact and number of deaths linked to HBV in Zimbabwe are very high. Chronic HBV infection is a leading cause of liver cirrhosis and liver cancer, both of which are often fatal. According to the World Health Organization, around 1,600 people in Zimbabwe die each year from chronic hepatitis B. However, local research models suggest the true number may be closer to 2,500 deaths annually when including all related causes like liver cancer. These numbers show how hepatitis B can be a silent, yet deadly, disease and underline the urgent need for better prevention and healthcare plans.

HBV spreads through contact with infected blood or bodily fluids. This can happen in several ways:

• From a mother to her baby during birth.
• During early childhood (often through close contact in households).
• Through unsafe medical injections.
• Via unscreened blood transfusions.
• Through unprotected sex.
• Through accidental exposure in healthcare settings (for example, needlestick injuries).

Because of these transmission routes, HBV safety in Zimbabwe relies on strong measures to prevent and control infections. Important steps include:

• Screening all donated blood for HBV.
• Using safe injection practices and sterile equipment.
• Ensuring medical tools are properly sterilized.
• Making post-exposure preventive treatment available.
• Vaccinating healthcare workers and other high-risk groups as a standard practice.

Vaccination is the single best way to prevent hepatitis B. Zimbabwe has included the hepatitis B vaccine in its routine childhood immunization program. Coverage for the three-dose infant series is high, at about 88–90% in recent years. This success has greatly reduced new infections in children. However, there is still a challenge in reliably giving the very first dose—the "birth dose"—within 24 hours of delivery. This first shot is crucial for preventing transmission from a mother with hepatitis B to her newborn baby.

While there are effective antiviral medicines that can control the virus and stop liver damage from getting worse, access to testing and treatment for HBV in Zimbabwe is still limited. A large number of infected people have not been diagnosed, and many who need treatment are not receiving it. To improve HBV safety, the country must:

• Expand screening programs.
• Integrate HBV services into existing healthcare programs for HIV and primary care.
• Improve access to affordable antiviral drugs.
• Strengthen national data collection systems to track the disease.

Hepatitis B virus (HBV) remains a major public health challenge in Zimbabwe due to its high prevalence, silent progression, and strong association with liver cirrhosis and liver cancer. A significant proportion of the population is chronically infected, yet many individuals remain undiagnosed because early infection is often asymptomatic. Although Zimbabwe has achieved high infant hepatitis B vaccination coverage, gaps persist in timely birth-dose administration, screening, and access to treatment. HBV-related morbidity and mortality remain substantial, highlighting weaknesses in surveillance and healthcare access. Strengthening vaccination, infection prevention and control, routine screening, and access to antiviral therapy is essential to reduce transmission, prevent complications and improve long-term health outcomes in Zimbabwe.